Barriers to orthopaedic practice--why surgeons do not put into practice what they have learned in educational events.

Background: All orthopaedic and trauma surgeons attend educational events throughout their careers. Many surgeons find that when they return to practice they are unable to put into effect those things that they have learned.

Methods: This study focussed on 708 surgeons from 2 different cultural backgrounds (developed and developing world) who attended 7 separate trauma Educational events. Surgeons were contacted by e-mail at least 6 weeks after the event and asked if they had encountered any Barriers, which had prevented them from putting into practice what they had learned at the event. If Barriers had been encountered they were asked to categorize them and state if they were able to overcome them.

Results: Barriers affect nearly every learner and learners are usually unable to overcome them. The study identified what barriers exist for implementation of acquired knowledge, how they vary with the degree of experience of the surgeon and his or her cultural background.

Conclusion: The commonest barrier amongst all surgeons is not having contact with a suitable patient to treat with their new knowledge and skills. Inability to get access to equipment and facilities is a major barrier for many surgeons especially in the developing world. This has profound implications for organizers of educational events that will need to incorporate strategies into their educational planning to help surgeon learners avoid or overcome barriers.